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Difficult pt, "weird" family dynamics: Tell me why I chose nursing again?



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Jul 12, 2009 06:43 PM

Difficult pt, "weird" family dynamics: Tell me why I chose nursing again?


We admitted a new pt a couple of days ago with a dx of brain CA, and all seemed "normal" at first. However, true to the nature of nursing, things went to hell in a handbasket from there. A man showed up who said he was the pts son and POA, and completely flipped out over the fact that "Dad" was in a "nursing home". (We are a rehab/AL facility, units are separate). We could not convince this man we did not "do" long-term pts unless the families wanted to private pay. Moving on, he continued to rant and rave about never wanting "Dad" in a nursing home and he was going to take him home right now, etc. Turns out, this guy is actually the grandson, and is NOT the POA. Evidently, there is a substantial amount of money tied up with the pt. Hmm. The sister of the pt is the actual POA and caretaker at home. Upon observing the interaction between her and the pt, one gets the very distinct impression that there is far more to their relationship than that of...well...normal brother/sister relationships. Several other nurses have commented to each other about seeing the same thing. Eww. Anyway, this pt is the proverbial "Pt from Hell". He yells out about how we are punishing him, how horrible "it" all is, how he's never been so miserable in his life, how he's going to throw himself in the floor, etc. He's as stiff as a board when you try to transfer him. But, as soon as he's in his w/c, he will miraculously go as limp as a wet rag and tries to scoot himself out of the chair and into the floor. His skin tears very easily d/t his dx and tx's, and his sister very nearly fell apart for a 3cm ST he rec'd from having to be hoisted back up into his chair. Naturally, he acts up worse when "sis" is around. According to her, he is ambulatory at home. ??? I understand his dx and radiation tx's have likely wreacked havoc on his cognition, but OMG! The saving grace is that he's already refusing therapy, family is unhappy, so I'm hoping he'll go back home very, very soon. (Today would be good!). Families/pts like these make me wonder just what I was thinking when I chose nursing for a career. They also make me grateful for my little dysfunctional family. I'd love to hear (read) stories of your diff pts/families! There seem to be so many...


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5 Comments
No. 1
Old Jul 12, 2009, 07:32 PM

Default Re: Difficult pt, "weird" family dynamics: Tell me why I chose nursing again?
You have my sympathies!! I work in LTC and see these behaviors (both pts & families) on a regular basis.........oh, well, at least I can leave the facility at the end of the shift, while they have to live with themselves every day.
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No. 2
from Sonjailana
Old Jul 12, 2009, 07:34 PM

Default Re: Difficult pt, "weird" family dynamics: Tell me why I chose nursing again?
It's awful..but I tell myself I have good intentions and can only do so much..and hope they're gone when I get back!
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No. 3
Old Jul 13, 2009, 12:16 AM

Default Re: Difficult pt, "weird" family dynamics: Tell me why I chose nursing again?
Call me weird (as all fellow nurses do). I kinda like the having the odd pt. I work overnight and it keeps me challenged. Don't get me wrong, It can get frustating at times. I am no saint.
I find everyone is dysfunctional in their own way but when I get a real doosy it makes me feel more normal. There will always be people out there like this. If you can accept that there is no avoiding them and deal with them head on, makes it all the more easier. And possibly interesting too. Makes for good story at least.
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No. 4
Old Jul 13, 2009, 09:08 PM

Default Re: Difficult pt, "weird" family dynamics: Tell me why I chose nursing again?
Just as it takes all kinds of nurses, it takes all kinds of patients and families. I'll never forget one woman and her daughter. The mother was totally demented and had all sorts of wild thoughts. She told her daughter that I came into the building one night, put her in a wheel chair, put her in my car, and drove her out to the Big E which is a fair in Western Mass. The daughter marched out to the nurses' station and started to holler at me because I took her mother for a ride without permission. My co-workers were laughing so hard they all had to excuse themselves. At least this one was harmless. I've been screamed at, spit on, sworn at and threatened with a bomb by nutty family members. I try to remember that the RESIDENT is the one who matters. AND it makes me hope and pray that MY kids don't turn into crazies if I ever have to be a patient.
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No. 5
from Bokyo
Old Jul 27, 2009, 07:13 AM

Default Re: Difficult pt, "weird" family dynamics: Tell me why I chose nursing again?
There are too many of them....
But never had problems with them...yes they do so many weird things, too much complains, families who can't understand the situation, who can't let go of a dying member....but it is always how you communicate with them and showing them your sincere/genuine care, then you'll get their TRUST and will not give you a hard time. They will just follow and believe what you say....
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